[The current role of the Swan-Ganz catheter]

Nearly forty years ago, Swan and Ganz introduced pulmonary artery catheterization to monitor the hemodynamic status of critical patients. The need for pulmonary artery catheterization in clinical practice has been questioned because it may be related to increased mortality and because alternative techniques that will probably cause less morbidity and mortality have been developed. The introduction of color Doppler echocardiography has been fundamental in the hemodynamic and etiologic evaluation of critical patients and has made it possible to clarify many clinical situations in which the response to treatment was unacceptable. This review aims to discuss the advantages and drawbacks of the Swan-Ganz catheter as the gold standard for monitoring hemodynamics in critical patients. We believe that combining the available techniques should help us evaluate the hemodynamics in critical patients and determine the cause of hemodynamic instability so we can select the most appropriate initial treatment and evaluate the subsequent response.